Overlap of Thrombotic Microangiopathy and Mesangial Proliferative Glomerulonephritis Caused by Combination Therapy with Atezolizumab and Bevacizumab

Vascular endothelial growth factor inhibitors and checkpoint inhibitors are effective treatments for solid tumors. These new classes of anti-cancer agents frequently cause kidney-related side effects. Although their anti-cancer effects may be enhanced when used in combination, the severity of their...

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Bibliographic Details
Published in:	Internal Medicine 2023/01/01, Vol.62(1), pp.91-94
Main Authors:	Horino, Taro, Eguchi, Tomohiro, Inotani, Satoshi, Hirose, Akira, Ishihara, Masayuki, Yagyu, Kenichi, Uchida, Kazushige, Fujieda, Mikiya, Terada, Yoshio
Format:	Article
Language:	eng
Subjects:	Aged anti-VEGF inhibitor Antitumor agents atezolizumab Bevacizumab Bevacizumab - adverse effects Carcinoma, Hepatocellular - drug therapy Case Report checkpoint inhibitor Glomerulonephritis Glomerulonephritis - chemically induced Glomerulonephritis - drug therapy Hepatocellular carcinoma Humans Immune checkpoint inhibitors Internal medicine Intravenous administration Kidneys Liver Neoplasms - drug therapy Male mesangial proliferative glomerulonephritis Methylprednisolone Prednisolone Side effects Solid tumors Thrombotic Microangiopathies - drug therapy Thrombotic microangiopathy Vascular endothelial growth factor Vascular Endothelial Growth Factor A
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Summary:	Vascular endothelial growth factor inhibitors and checkpoint inhibitors are effective treatments for solid tumors. These new classes of anti-cancer agents frequently cause kidney-related side effects. Although their anti-cancer effects may be enhanced when used in combination, the severity of their kidney-related side effects is unknown. We herein report the first case of thrombotic microangiopathy and mesangial proliferative glomerulonephritis caused by combined treatment with atezolizumab and bevacizumab in a 74-year-old man with hepatocellular carcinoma. The combination therapy was discontinued and replaced with intravenous methylprednisolone followed by oral prednisolone. Subsequently, the urinary protein excretion levels declined.
ISSN:	0918-2918 1349-7235